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Advantage Health, the primary care physicians’ practice owned by Saint Mary’s Health Care, is about one-third of the way into a 10-year growth plan to double its size, CEO Dr. David Blair said.

Three new buildings, plus a presence in Saint Mary’s Southwest Center at M-6 and Byron Center Avenue SW, are the most visible signs of Advantage Health’s new direction, Blair said. This year’s construction for the 12-office practice includes: a move of the Caledonia office into a larger, 14,154-square-foot building at 10047 Cross Road Court last spring; a September move into a new 61,028-square-foot-building at 1471 East Beltline Ave. NE, more than doubling the number of doctors practicing there; and combining offices in the Alpine and Standale areas into a 16,551-square-foot facility in Standale, expected to open in November.

Advantage Health did not provide the cost of the construction investment.

Advantage Health and Highpoint Real Estate & Development formed a new limited liability corporation to construct, own and lease the buildings. Some individual Advantage Health physicians are investors in the LLC, Blair said.

“We help them in site selection, development and property management,” added Steve Plakmeyer, a manager at Highpoint. Advantage Health occupies part of the buildings, while other Saint Mary’s-related tenants, such as laboratory, imaging and rehabilitation services, lease the remainder, Plakmeyer said.

The new bricks and mortar are aimed at accommodating more doctors and patients in areas of population growth in West Michigan, Blair said.

After Saint Mary’s bought a 25-doctor family practice in 1994, an initial growth spurt put Advantage Health at 80 doctors.

“We then felt that it was important to consolidate and get our economics more under control,” Blair said. “So we stayed at a size of about 80 doctors for about five years. We then engaged a consulting team, and looked at our opportunities and decided to embark on a growth plan that would approximately double the size of our organization.”

As part of that plan, Advantage Health has hired 17 doctors so far this year. The medical staff is expected to reach 115 by the end of 2007, Blair said. Advantage Health employs a total of 336. Its board of directors includes five representatives of Saint Mary’s and five doctors, Blair said.

“We are continuing to plan to grow,” Blair said.

Advantage Health’s doctors practice under the auspices of family medicine, internal medicine, obstetrics and gynecology, pediatrics, geriatrics and a combination of internal medicine and pediatrics.

In the managed care heyday of the 1990s, primary care physicians were the darlings of health care, touted as the gatekeepers who controlled patients’ access to specialists, according to a 2006 report from Merritt, Hawkins & Associates, a Texas physician staffing firm. But today, morphing payment models, patient demands and technology have pushed demand for specialists much higher than demand for their primary care colleagues, the report stated. Merritt, Hawkins reported that in its own work over the past two years, however, demand seems to be perking up for family physicians and internists, while still slow for pediatricians.

Most of Advantage Health’s new doctors are freshly minted, Blair said. Establishing a new practice is an expensive and time-consuming endeavor for young physicians, and the opportunity to avoid those headaches makes working for an organization such as Advantage Health attractive, he added.

“There are economies of scale. You can accomplish things that are so very hard for a one- or two- or three-physician practice to take on. It’s a hard business to get started in. A new doctor who already comes out with an established debt of $150,000 — on some occasions $200,000 — when they come out of medical school, to think that you’re then going to borrow money to start a practice, and, further, you won’t have much cash flow the first year or two because you won’t have many of your own patients — it’s essentially impossible to start by yourself,” Blair said. “And it still is a struggle for small practices to start a new doctor. It’s not impossible, but it’s hard.”

Dr. Channing Finkbeiner joined Advantage Health in March after four years of practicing in Big Rapids. The move brought Finkbeiner, his wife, Laura, and their sons closer to Laura’s job as a second-grade teacher at Byron Center Public Schools’ Marshall Elementary. “I’m from this area, so it was somewhat of a no-brainer,” said Finkbeiner, a 1999 graduate of Michigan State University’s College of Human Medicine.

While doing his residency in Grand Rapids, Finkbeiner said he had many occasions to interact with Advantage Health doctors.

“These were my mentors, the people I looked up to in medical school and residency,” he said. So when the couple made the decision to move to Grand Rapids, he called Advantage Health.

“The overall lifestyle and practice that they had was something I really wanted. One of the big advantages for me is they ask you and work with you on what kind of practice you want to cultivate, and are extremely supportive in whatever role that is,” said Finkbeiner, who works in the Kentwood office. “The financial piece comes second.”

Seventy-five percent of the nation’s health care spending goes toward treating chronic conditions, and Blair said Advantage Health is trying to leverage information technology to make that task easier for primary care physicians, despite software that lags behind other industries. For example, Blair grasped a thick packet of printouts containing information about his diabetic patients: Blood test results, blood pressure readings and foot checks are some examples of information needed to track a diabetic’s care. Blair’s database highlighted patients who had undesirable blood test results. It sounds simple enough, but gathering those facts from laboratories, other doctors and his own staff and putting the data into a useable format that improves patient care requires an effort far beyond the typical medical record stored in a manila folder, Blair said.

With such challenges ahead, Advantage Health is continuing its march toward growth and change, he added.

“There’s a need out there. The population is aging. There’s actually fewer physicians that are going into primary care, and we’re working to help that primary care practice model be successful and be a rewarding experience for people.” HQX

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